Clubfoot

Condition Basics

What is clubfoot?

Clubfoot (also called talipes equinovarus) is a general term used to describe a range of unusual positions of the foot. Each of the following characteristics may be present, and each may vary from mild to severe:

• The foot (especially the heel) is usually smaller than normal.
• The foot may point downward.
• The front of the foot may be rotated toward the other foot.
• The foot may turn in, and in extreme cases, the bottom of the foot can point up.

Most types of clubfoot are present at birth (congenital clubfoot). Clubfoot can happen in one foot or in both feet. In almost half of affected infants, both feet are involved.

Although clubfoot is painless in a baby, treatment should begin immediately. Clubfoot can cause significant problems as the child grows. But with early treatment most children born with clubfoot are able to lead a normal life.

What causes clubfoot?

All of the causes of clubfoot are not well understood. It can develop because of the position of the baby while it is growing in the mother's uterus. Having other health conditions such as spina bifida can also cause clubfoot. It can also be the result of problems that affect the nerve, muscle, and bone systems, such as stroke or brain injury. Shortly after birth, your baby may be tested for some of these problems.

What are the symptoms of clubfoot?

Clubfoot can have many symptoms, which may vary from mild to severe:

• The foot, especially the heel, is often smaller than normal.
• The foot may point downward.
• The front of the foot may rotate toward the other foot.
• The foot may turn in, and in severe cases, the bottom of the foot can point up.

Clubfoot does not cause pain in a baby. But the leg that is affected may be shorter and smaller than the other leg. These symptoms become more obvious and more of a problem as the child grows. Your child may have problems playing like other children because of clubfoot. And your child may have problems with walking and finding shoes that fit. Treatment that starts soon after birth can help overcome these problems.

How is it diagnosed?

Ultrasound done before your baby is born can sometimes detect clubfoot. It is more common for your doctor to diagnose the condition after the infant is born based on how the feet and legs look and move. In some cases, especially if the clubfoot is due just to the position of the growing baby before birth (postural clubfoot), the foot is flexible and can be moved into a normal or nearly normal position after the baby is born. In other cases, the foot is more stiff, and the muscles at the back of the calf are very tight.

How is clubfoot treated?

Treatment starts soon after birth. Your doctor may try putting a cast or splint on the foot or feet first. This means the foot (or feet) is moved into the most normal position and held in that position until the next treatment. Treatment is repeated every few weeks for several weeks. The foot is moved a little closer toward a normal position at each visit.

Your doctor may do surgery if the cast or splint isn't working or if the foot is severely out of place. The most common surgeries repair ligaments and tendons, such as the heel cord (Achilles tendon). After surgery, a foot brace holds the foot in place while it heals. Your child may have physiotherapy.